I ASKED WHY. THE ONE WHO SAID SHE WAS SATISFIED SAID, "MY DOCTOR LISTENS TO ME, AND HE TELLS ME WHAT THE PROBLEMS ARE, WHAT HE'LL DO, AND I HAVE A LOT OF CONFIDENCE IN HIM." THE ONE WHO WAS DISSATISFIED SAID, "I'M FURIOUS AT MY DOCTOR. IN ORDER TO HAVE SOME SURGERY DONE, I SAW HIM 7 TIMES IN 2 WEEKS, HAD VARIOUS TESTS AND CONSULTATIONS, AND WHEN I CALLED HIM TO ASK A QUESTION, HE SAID, `NOWREMIND ME WHO YOU ARE AND WHY I KNOW YOU.`" 126 I SAID TO THEM BOTH, "IN OTHER WORDS, WHEN I ASKED YOU -AREYOU SATISFIED WITH YOUR HEALTH CARE?`, ONE OF YOU SAID "YES", ONE SAID "NO", BUT WHAT YOU REALLY WERE SAYING IS THAT ONE OF YOU LIKED YOUR DOCTOR AND ONE OF YOU DIDN'T. ONE HAD CONFIDENCE IN YOUR DOCTOR, ONE DID NOT." 127 THEREFORE, MY MESSAGE TO THE DOCTORS IN AMERICA IS: WHEN YOU ARE DEALING WITH A PATIENT YOU ARE REPRESENTING ALL OF AMERICAN MEDICINE, YOU ARE REPRESENTING AMERICAN HEALTH CARE. 128 WE HAVE MUCH TO DO, BUT LETS NOT LOSE OUR POSITIVE ENERGY. THE MESSAGE WE HAVE TO SHARE WITH OURSELVES AND WITH THE AMERICAN PEOPLE IS A POSITIVE ONE. WE DON'T NEED THE PAST TENSE,... NOSTALGIA ABOUT "THE GOOD OLD DAYS"; 129 NOR DO WE NEED SOME FUTURISTIC MANIFESTO PROMISING WHAT WE INTEND TO DO. WE NEED CLEAR AND PERSISTENT AFFIRMATION OF THE MANY GOOD THINGS WE DO, DAY IN AND DAY OUT, TO MAKE OUR SYSTEM OF MEDICINE --ONCE WE TAKE THINGS IN HAND -- POTENTIALLY THE BEST IN THE WORLD. 130 I HAVE NEVER REGRETTED GOING INTO MEDICINE. I'D DO IT AGAIN TOMORROW. AND I TELL THAT TO ANY YOUNGSTERS WHO ARE CONSIDERING IT. OURS IS A CALLING. IT IS NOT A BUSINESS. WE COULD HAVE MADE MONEY DOING OTHER THINGS. 131 WE CHOSE MEDICINE --SURGERY-- BECAUSE IT COMBINED A QUEST FOR KNOWLEDGE WITH A WAY TO SERVE, TO SAVE LIVES, AND TO ALLEVIATE SUFFERING. WE HAVE TO CONVINCE THE PUBLIC WE STILL MEAN IT. IF WE DO, WE'LL GET WHAT WE NEED TO DO THE JOB RIGHT. 132 I THINK I POSSESS A CERTAIN AMOUNT OF CREDIBILITY, BOTH WITH YOU AND THE GENERAL PUBLIC. I HOPE MY REMARKS TO YOU TODAY DID NOT COST ME SOME OF MY CREDIBILITY WITH SOME OF YOU BECAUSE YOU DON'T LIKE WHAT I SAID. I THINK YOU ALL KNOW THAT MEDICINE IN AMERICA IS IN DEEP TROUBLE, MAYBE AT A TRUE CROSSROADS. 133 IF YOU DON'T WANT TO SEE US TAKE THE ROAD TO CANADA, OR il@$# GREAT BRITAIN, DO SOMETHING NOW. WE MUST DO SOMETHING, SOMETHING TO REKINDLE THE LOVE OF OUR PROFESSION, THE PRIDE IN LOliTY ETHICS, THE ENJOYMENT OF MEDICINE. DON'T JUST WRING YOUR HANDS AND GRUMBLE BECAUSE "THEY" HAVEN'T DONE SOMETHING. YOU ARE THEY. THANK YOU. ###### 134 SPEECH "EXASPERATION ON BOTH SIDES OF THE STETHOSCOPE" AMERICAN COLLEGE OF SURGEONS SAN FRANCISCO, CA OCTOBER 8,199O C. EVEREYT. KOOP, MD 135